Train your trainees

I’ve been spending a lot of time in labour ward anaesthesia this past month. It’s great, because I get all the gratification of the caesarian sections (I remember it well from internship), without having to wade through blood and amniotic fluid and human excreta myself.

This tweet in part inspired this post.

Another thing I remember well, is the tension in theatre when the intern is cutting. I had such difficulty getting my ten caesarian sections for our logbook signed off, because so few seniors were willing to let an intern cut. It’s not only the obstetrician – often, it’s the theatre nursing staff. To be fair, nobody likes to be scrubbed in for a routine caesarean that lasts ninety minutes. Other times, it’s the anaesthetists. Because nobody likes to worry that their spinal anaesthetic might wear off before the surgery is over.

I have had a taste of the same with my new position, too. Not having done anaesthesia in four years, there is a lot I have had to relearn. My “teachers” have been great, and I seem finally to be finding my feet, but there have often been grumblings from surgical teams when I was slow. As an intern, I might have minimised myself and declined to perform the procedure. But now, I need to learn, and quickly. So I have been pushing back harder (when not to the patient’s detriment) – and to my new colleagues’ credit, they have supported me.

Check the replies on this tweet – they made me feel so much better.

Having experienced this, I will always be the annoying medical officer who encourages the intern/student/newbie to perform procedures. Not because I think I’m so wonderful, but because I want trainees to feel as nurtured as I have felt these past few months, and not as burdensome as I sometimes did as a student and an intern.

Sometimes, I think clinicians forget that they were inexperienced and under-qualified juniors once, too. There is nothing admirable about learning to place an intercostal drain on YouTube, without senior supervision, as many of us like to brag. That is a sign of a failing system. We should be taught and guided by others with experience. We deserve that. Our patients deserve that.

I also know that it is a system that fails not only interns. I know that demoralised doctors have little interest in training juniors. (But that is a discussion for another day.)

Interns who are not competent become dangerous medical officers, wherever they may go for ComServe. They have both the right and the responsibility to be trained. We have the responsibility to ensure that they attain their very best, even if they are afraid while doing so. We do it to pay forward the teaching we have received. Or if we were not so fortunate, we do it to improve where others failed us.

Train your trainees. It kind of goes without saying.

My Advice for Your ComServe Application

It’s almost time for the asynchronous community service applications in SA, and shortly thereafter the regular applications will begin. So I thought I’d take a break from dispensing medicine, and dispense a tip I could have used:

Apply somewhere that is going to challenge you.

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Zithulele, Eastern Cape, where I went in my final year for Family Medicine. A fantastic Community Service option.

Apply somewhere that you will be expected to work with a reasonable level of independence. Probably the best place to do community service, in my opinion, is somewhere that you can do emergency medicine, or at least your overtime in emergency medicine. Yes, even if you don’t want to do EM in the long run. Continue reading “My Advice for Your ComServe Application”

Questions on Blogging for Readers Past/Present/Future

I started this blog exactly eight years ago, today.

Who I was then, and who I am now, has changed drastically, and often. I wrote as I stumbled my way through new clinical and life experiences. I wrote as my mental health peaked and plummeted. I wrote as my love for medicine died, and was reborn. The first community I found was that of book bloggers, but gradually, I found the medical bloggers, too.

Continue reading “Questions on Blogging for Readers Past/Present/Future”

Are We Secretly Our Own Worst Enemies?

If you’ve been reading South African news, you’ll know that at least 300 interns and community service doctors stand to be unemployed next year, due to a lack of funded posts at accredited institutions.

Perhaps you read about our inhumane working hours last year.

Perhaps you have read about the overflowing hospitals where patients pile up in the corridors.

These are not new problems, we just hear about them more because doctors and patients have phones with cameras, and social media accounts.

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Continue reading “Are We Secretly Our Own Worst Enemies?”

The Threat of Fun-employment

In final year, we thought that getting an internship post at our desired hospital was the hardest – and most coveted – thing.

Two years later, we all tried to find a community service posting that would give us a foot into the door to our future specialties.

But we didn’t know that those were the easy parts. Then, we still pretty much had guaranteed employment (most of us, at least).

Then came the end of Community Service, and reality hit us in the face: we were on our own.

* * *

That’s where I am now. The government no longer “owes” me a job, and unless I find one, I’ll be unemployed come January 2018. People used to say, “There’s no such thing as an unemployed doctor.” These days, there are plenty of them, because freezing posts is a done thing. Continue reading “The Threat of Fun-employment”

Working in the Land of Milk and Honey

I recently realised that some of my posts have disappeared into thin air. I’m not sure how, but I’m reposting them courtesy of the web archive.

By some kind of dumb luck, I am doing my Community Service posting at an incredible children’s hospital in Cape Town, rather than the archetypal middle-of-nowhere clinic post we all expect for ComServe.

And it’s incredible.

This hospital is just something else. It’s public, but has so much private funding that it might as well be a private hospital. It gets a lot of private patients so clearly I’m not alone in my perception.

Some things that continue to blow my mind: Continue reading “Working in the Land of Milk and Honey”